Therapy Intake Questions to Ask New Clients

By Veronica West, Registered Psychologist BPsychSc(Hons), MPH, MPsych

Most clinicians have an intake routine they've refined over the years, and still finish some first sessions realising they forgot to ask about something important, or ran out of time before getting to the client's goals. A clear set of therapy intake questions gives the first session a structure, so you can cover history and risk while the client still leaves feeling listened to. This article works through 40 intake questions for therapy, grouped by area, along with what belongs on the intake form and what's better asked in the room.

What Does a Therapy Intake Need to Cover?

A therapy intake is the first assessment session with a new client, where you gather enough information to understand why they've come, assess risk, and start a working formulation. It's also the client's first experience of you, and a client who feels rushed or interrogated may not come back for a second session.

Biopsychosocial assessment: an approach that looks at the biological, psychological, and social factors contributing to a client's difficulties, rather than the symptoms alone. In practice this means asking about the presenting concern, history, physical health, relationships, work, culture, and strengths, and then organising that information into a formulation. Many clinicians use the 5 P's (presenting, predisposing, precipitating, perpetuating, and protective factors) to pull it together.

What to Ask on the Intake Form and What to Ask in Session

Anything factual the client can answer at home belongs on the intake form, which frees up the session for the questions that need a conversation. One way to divide it up:

Area	On the intake form	In the session
Contact and admin	Contact details, emergency contact, referrer and GP, funding or insurance details	Anything unclear on the form
Consent and privacy	Signed consent, privacy and confidentiality information	The limits of confidentiality, in plain language
Health	Current medications, prescriber, physical health conditions	How health is affecting mood, sleep, and energy
Mental health history	Previous treatment and diagnoses, briefly	What helped before and what didn't
Symptoms	Standardised measures such as the K10, DASS-21, PHQ-9 or GAD-7	The client's own description of the problem
Risk	A brief screening item, if your service uses one	A direct, face-to-face risk assessment
Goals	What the client hopes to get from therapy	What change would look like day to day

If you'd rather not build these forms from scratch, our Intake Questions for Therapy Bundle includes client detail and consent forms, an intake assessment, a client questionnaire, and a mental status exam, all editable in Canva.

Questions About the Presenting Concern

Start with the client's own account. Open questions help here, and it's worth letting the client talk for a while before you narrow things down.

1. What brings you to therapy at this point in time?
2. Why now? What made you decide to reach out now rather than earlier?
3. When did you first notice this?
4. How often does it happen, and how long does it last?
5. What makes it better, and what makes it worse?
6. How is this affecting your work, study, relationships, or sleep?
7. What have you already tried, and did anything help, even a little?
8. On a scale of 0 to 10, how distressing is this for you right now?

The "why now" question often points to a precipitating event the client hasn't yet connected to how they're feeling, which is useful for the formulation.

History and Background Questions

History questions fill in the context around the presenting concern. I usually tell clients at this point that they don't need to go into detail about difficult experiences today, and in my experience that makes it easier for them to mention that something happened at all.

Mental health and medical history:

• Have you seen a psychologist, counsellor, or other mental health professional before? What was helpful, and what wasn't?
• Have you been given any mental health diagnoses?
• Have you ever been admitted to hospital for your mental health?
• Are you taking any medications, and who prescribes them?
• How are your sleep, appetite, and energy at the moment?

Alcohol and other substances:

• How much alcohol do you drink in a typical week?
• Do you use cannabis or any other drugs, including medications that weren't prescribed to you?
• Has anyone ever been worried about your drinking or drug use?

Family and life history:

• Who was in your family growing up, and what was home like?
• Is there any history of mental health difficulties or substance use in your family?
• Have there been any significant losses, changes, or difficult experiences that still affect you?

Risk Assessment Questions

Risk questions belong in every intake, and they're easier to ask when you explain that you ask all new clients the same questions. In a systematic review by Dazzi and colleagues (2014), there was no evidence that asking directly about suicide increases suicidal thinking, and many clients are relieved to be asked plainly.

• Have you had thoughts that life isn't worth living?
• Have you had thoughts of ending your life? When was the last time?
• Have you made any plans, or taken any steps towards acting on those thoughts?
• Have you ever tried to end your life in the past?
• Have you hurt yourself in other ways, such as cutting or burning?
• What has stopped you from acting on these thoughts?
• Is anyone hurting you, threatening you, or making you feel unsafe?
• Have you had thoughts of harming someone else?

Any positive response needs follow-up in line with your organisation's risk procedures and your professional obligations. For clients who need one, completing a written safety plan together before they leave gives them something concrete to use between sessions, and our Safety Plan Worksheets Bundle can help with this.

Questions About Relationships, Work, Culture, and Strengths

The social part of the assessment tells you what the client's life looks like around the problem, and where their support comes from.

• Who do you live with?
• Who do you turn to when things are hard?
• How are things at work or study at the moment?
• Are there cultural, spiritual, or community parts of your life that are important for me to understand?
• How do you like to spend your time when you're feeling well?
• What are you good at, and what do the people close to you appreciate about you?
• What has helped you get through difficult times before?

Strengths questions are easy to drop when time is short. It's worth keeping them, as they give you the protective factors for your formulation and mean the history section doesn't end only on problems.

Goals, Expectations, and Closing the Intake

The last part of the intake turns the assessment into a plan. I leave at least ten minutes for it, so the client goes home understanding what happens next.

• What would you like to be different by the end of therapy?
• How will you know therapy is helping? What would you notice first?
• What are you hoping to get from me in our sessions?
• Is there anything that worries you about starting therapy?
• Is there anything I haven't asked that you think is important for me to know?
• How has today been for you?

Mental status examination (MSE): a structured record of your observations of the client during the session, covering appearance, behaviour, speech, mood, affect, thought form and content, perception, cognition, insight, and judgement. Most clinicians complete it after the session rather than asking it as a list of questions.

Finish by summarising what you've heard in a few sentences, checking you've understood it correctly, and agreeing on next steps. If you're seeing a couple rather than an individual, our guide to couples therapy questions for the first session covers how the intake changes, and our guide to cognitive behavioural therapy questions to ask clients picks up from the second session onwards.

A consistent set of therapy intake questions means you can spend the first session listening rather than trying to remember what comes next, and you finish with a clearer picture of the client, their risk, and what they want from therapy. Putting the factual questions on a form and keeping the conversational ones for the room gives the session a structure that works for both of you.

Veronica West is a registered psychologist (BPsychSc(Hons), MPH, MPsych) and the founder of My Thriving Mind, a digital resource library for psychologists, counsellors, and allied mental health professionals. The range includes the Intake Questions for Therapy Bundle, the Intake Forms for Therapy Client bundle with consent forms and BIRP, PIRP and SOAP progress note templates, the Child Biopsychosocial Assessment for intakes with children, and the wider intake forms collection. For clinicians who want everything in one purchase, the Whole Shop Bundle includes the full library of 1,000+ therapy resources.

Browse the intake forms collection here: https://mythrivingmind.io/collections/intake-forms-for-therapy-client